Oral Manifestations of Systemic Pathology

Systemic gold therapy for rheumatoid arthritis may produce oral pigmentation similar to that of Addisons disease. Bulimia leads to parotid enlargement and erosion of the teeth due to regurgitation of acid. Erysepelas is the infection of the dermis and the subcutaneous tissue including lymphatics, caused by Streptococcus pyogenes. Clinically it is seen as sharply demarcated, painful, raised, red lesions with orange peel (peau-de-orange) appearance. Erythema multiforme may cause extensive crusting of lips or intra oral vesicles and bullae. Intra oral bullae are a prominent feature of pemphigus vulgaris, they are either yellow or haemorrhagic and burst to leave an area of ulceration. Lichen planus classically affects the mouth giving erosive lesions or producing "cotton wool" patches.